Department of Psychiatry, University of California, San Francisco, CA, USA.
Department of Psychiatry, University of California, Los Angeles, CA, USA.
Neurosci Biobehav Rev. 2018 Dec;95:383-395. doi: 10.1016/j.neubiorev.2018.10.013. Epub 2018 Oct 28.
Anorexia nervosa (AN) is an often chronic and potentially lethal psychiatric disorder, for which the precise etiology remains elusive. While current treatment outcomes are modest at best, it is thought that the identification of translational mechanisms driving the psychopathology of AN will assist in the development and optimization of novel treatments. AN is a disorder characterized by fear and avoidance, hypervigilant scrutiny of one's body, and an unnatural fear of weight gain. Moreover, a suite of anxious traits and regimentation of behavior are atypically common well in advance of the onset of restrictive eating in those with AN. Here we consider the promise of shedding light on causal mechanisms of AN by interrogating the role of fear-related learning, deficits in discriminating safety cues, and extinction of acquired fear. We offer a translational rationale for this line of inquiry, and discuss the clinical implications of considering fear as a translational mechanism in the psychopathology of AN.
神经性厌食症（AN）是一种常见的慢性且可能致命的精神疾病，其确切病因仍难以捉摸。虽然目前的治疗效果充其量只是一般，但人们认为，确定推动 AN 精神病理学的转化机制将有助于开发和优化新的治疗方法。AN 是一种以恐惧和回避为特征的疾病，对自己的身体进行过度警惕的审视，以及对体重增加的不自然恐惧。此外，在 AN 患者出现限制性进食之前，就会出现一系列焦虑特征和行为规范。在这里，我们通过研究与恐惧相关的学习、辨别安全线索的缺陷以及习得性恐惧的消除在 AN 中的作用，来探讨揭示 AN 因果机制的前景。我们为这一研究方向提供了转化的基本原理，并讨论了将恐惧视为 AN 精神病理学中的转化机制的临床意义。
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